[Differentiated treatment strategy for peritonitis: single stage closure with drainage or open with programmed...

307 Patients with intraabdominal infections were operated between 8/1988 to 8/1991. Simple clinical parameters (according to the Mannheimer Peritonitis-Index) were evaluated before treatment. The classical therapeutic concept of one-stage laparotomy with drainage of the abdomen was performed in 223 patients initially. Because of recurrent infection and other complications in 19% of them 1 - 2 relaparotomies had to be done, and in 8% change to open treatment was necessary. Open treatment with planned relaparotomy was necessary in alltogether 101 patients, 93 abdominal complications due to primary disease or sepsis were detected in 43 of them. Abdominal treatment was successful (eradication of source of infection, no recurrence of infection) in 98% of the patients after closed and in 84% after open treatment. Mortality was 6.8% vs. 32.7% and on the whole 15.3%.